HomeMy WebLinkAbout03-26-15 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-96)
DEPAfiTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 020410
PUTT RICHARD G
504 LANCASTER AVENUE
ENOLA, PA 17025
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
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14141876 ( 530.00
ESTATE INFORMATION: SSN: � 14141874 � 544.61
FILE NUMBER: 2114-0805 101 � $5,925.39
DECEDENT NAME: PUTT SAMUEL W �
DATE OF PAYMENT: 03/26/2015 �
POSTMARK DATE: 03/26/201 5 I
COUNTY: CUMBERLAND �
DATE OF DEATH: 06/26/2014 I
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TOTAL AMOUNT PAID: 56,000.00
REMARKS: RECEIPT TO ATTY
CHECK# 8578
INITIALS: HMW
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES Pennsylvania lnheritance Tax • pennsylvania
PO BOX 280601
HARRISBURG PA 17128-0601 Information Notice DEPARTMENT OF REVENUE
And Taxpayer Response pEY-159!EX DocE%EL c�e-iz�
FILE NO.21
ACN 14141876
DATE 07-23-2014
Type of Account
Estate of SAMUEL W PUTT Savings
SSN Checking
Date of Death 06-26-2014 Trust
RICHARD G PUTT County CUMBERLAND Certificate
504 LANCASTER AVE
ENOLA PA 17025-2636 _.,9
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MEMBERS isr Fcu provided the department with the information below indicating that at the death'+of the
above-named decedent ou were a joint owner or beneficiary of the account identified.
Account No.3278 Remlt Payment and Forms to:
Date Establlshed 11-29-1954 REGISTER OF WILLS
Account Balance $4,000.27 7 COURTHOUSE SQUARE
Percent Taxable X 16.667 CARLISLE PA 17013
Amount Subject to Tax $666.73
Tax Rate X 0.045
Potential Tax Due $30.00 NOTE*: If tax payments are made within three months of the
With 5%Discounf(Tax x 0.95) $(see NOTE") decedent's date of death,deduct a 5 percent discount on the tax
due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1: Please check the appropriate boxes below.
1
A []No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was
21 years old or youn ger at date of dea t h.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
B �The'information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased.
(Select correct tax rate at
right,and complete Part � 12��, I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships (including none).
p �Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
PART Debts and Deductions
2
Aliowable debts and deductions must meet both of the following criteria:
A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items.
B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department.
(If additional space is required,you may attach 81/2"x 11"sheets of paper.)
Date Paid Payee Description Amount Paid
Total Enter on Line 5 of Tax Calculation $
PART Tax Calculation
3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3),
— please obtain a written correction from the financial institution and attach it to this form.
1. Enter the date the account was established or titled as it existed at the date of death.
2. Enter the total balance of the account including any interest accrued at the date of death.
3. Enter the percentage of the account that is taxable to you.
a. First,determine the percentage owned by the decedent.
i. Accounts that are held"in trust for"another or others were 100%owned by the decedent.
ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided
by the total number of owners including the decedent. (For example:2 owners=50%,3 owners=33.33°/a, 4 owners
=25%,etc.)
b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is determined by multiplying the account balance by the percent taxable.
5. Enter the total of any debts and deductions claimed from Part 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax.
7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent..
If indicating a different tax rate,please state
your relationship to the decedent:
1. Date Established 1
2. Account 8alance 2 $
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 �
5. Debts and Deductions 5 =
6. Amount Taxatile 6 $
7. Tax Rate � X
8. Tax Due � 8 $
9. With 5%Discount(Tax x.95) 9 X
Step.2: Sign and date below. Return TWO completed and signed copies to the Register of Wills Iisted on the front of this form,
along with a check for any pay,ment you are making. Checks must be made payable to"Register of Wills,Agent" Do not send
payment directly to the Department of Revenue.
Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and
belief.
WOrk
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Taxpayer Signat re Telephone Number Date ����rs
IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
�i DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020
BUREAU OF INDIVIDUAI 7AXES Pennsylvania lnheritance Tax � pennsylvania
PO BOX 280601
NARRISBURG PA ���Zs-o6o� Information Notice DEPARTMENT OF REVENUE
And Taxpayer Response REvisaa ex m�exEc cae-it�
FILE NO.21
ACN 14141874 �
DATE 07-23-2014
Type of Account
Estate of SAMUEL W PUTT Savings
SSN 193-12-7985 Checking
Date of Death 06-26-2014 Trust
RICHARD G PUTT County CUMBERLAND
504 LANCASTER AVE Certificate
ENOLA PA 17025-2636
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MEMBERS isr Fc provided the department with the information below indicating that at h�death�of the
above-named decedent you were a 'oint owner or beneficia of the account identified. �
Account No.3278 Remit Payment and Forms to:
Date Established 11-29-1954 REGISTER OF WILLS
Account Balance $5,947.95 1 COURTHOUSE SQUARE
Percent Taxable X 16.667 CARLISLE PA 17013
Amount Subject to Tax $991.34
Tax Rate ' X 0.045
Potential Tax Due $44.61 NOTE*: If tax payments are made within three months of the
With 5% Discount(Tax x 0.95) $(see NOTE') d�edenYs date of death,deduct a 5 percent discount on the tax
due. Any inheritance tax due will become delinquent nine months
after the date of death.
PART Step 1 : Please check the appropriate boxes below.
1
A �No tax is due. i am the spouse of the deceased or I am the parent of a�decedent who was
21 years old or younger at date of death.
Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount
shown above as Potential Tax Due.
B �The information is The above information is correct, no deductions are being taken,and payment will be sent
correct. with my response.
Proceed to Step 2 on reverse. Do not check any other boxes.
C �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent,child,grandchild,etc.)of the deceased.
(Select co�rect tax rate at .
right,and complete Part � 12q, I am a sibling of the deceased.
3 on reverse.)
� 15% All other relationships(including none).
p �Changes or deductions The information above is incorrect and/or debts and deductions were paid.
listed. Complete Part 2 and part 3 as appropriate on the back of this form.
E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax
inheritance tax form Return filed by the estate representative.
REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes.
Please sign and date the back of the form when finished.
PART Debts and Deductions
z
Allowable debts and deductions must meet both of the following criteria:
A. The decedent was legally responsible for payment,and the estate is insufficient to pay the deductible items.
B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department.
(If additional space is required,you may attach 81/2"x 11"sheets of paper.)
Pa ee Description Amount Paid
Date Paid Y
Total Enter on Line 5 of Tax Calculation $
�PART TaX CaICUIatIOn
If ou are making a correctlon to the establishment date(Line 1)account balance(Llne 2),or percent taxable(Line 3)�
— please obtain a written correction from the financial institution and attach it to this form.
1. Enter the date the account was established or titled as it existed at the date of death.
2. Enter the total balance of the account including any interest accrued at the date of death.
3. Enter the percentage of the account that is taxable to you.
a. First,determine the percentage owned by the decedent.
i. Accounts that are held"in trust for"another or others were 100%owned by the decedent.
ii. For joint accounts established more thart one year prior to the date of death,the percentage taxable is 100%divided
by the total number of owners including the decedent. (For example:2 owners=50%,3 owners=33.33%,4 owners
=25%,etc J
b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries.
4. The amount subject to tax is determined by multiplying the account balance by the percent taxable.
5. Enter the total of any debts and deductions claimed from Part 2.
6. The amount taxable is determined by subtracting the debts and deductions from the amount su6ject to tax.
7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent.;
If indicating a different tax rate,please state
your relationship to the decedent:
1. Date Established 1
2. Account Balance 2 �
3. Percent Taxabie 3 X
4. Amount Subjeet to Tax ` 4 �
5. Debts and Deductions 5 -
. 6. Amount Taxable 6 $
7. Tax Rate � X
8. Ta�c Due 8 $
9. With 5%Discount(Tax x .95) 9 X
Step,2: Sign and date below. Return TWO completed and signed copies to the Register of�Ils listed on the front of this form,
along with a check for any payment you are making. Checks must be made payable to"Register ot Wills,Agent." Do not send
payment directly to the Department of Revenue.
Under penalty of perjury, I declare that the facts i have reported above are true,correct and complete to the best of my knowledge and
belief.
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' Tele hone Number Date � z����
Taxpayer Signature p
IF YOU NEED FURTHER ASSISTANCE, CONTACT PENNSYLVANIA DEPARTMENT OF REVENUE
DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR
TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020